Characterization of Methyl and Ethyl Esters of Amino-Acids as Corneal Permeation Enhancers

@#Introduction: Amino acids are important role-playing components in the maintenance of the normal functions of parts of eye like retina and conjunctiva. In the current study the methyl and ethyl esters of amino acids such as lysine, phenyl alanine and valine were used to enhance the corneal permeation of ketorolac tromethamine. Methods: The amino-acid esters were coupled with the drug ketorolac tromethamine to obtain the test products and were characterized by various analytical techniques. The characterized test products were used to formulate the test ophthalmic solutions of Ketorolac tromethamine such as KPD-1, KPD-1A, KPD-2, KPD-2A, KPD-3 and KPD-3A with methyl and ethyl esters of corresponding amino-acids. These test products were subjected percentage corneal hydration and to permeation studies by using Franz diffusion cell mounted with freshly isolated goat cornea. Results: All the test results were compared with those of the standard Ketorolac tromethamine ophthalmic solution and observed that all the test solutions have exhibited less percentage corneal hydration and enhanced corneal permeation of ketorolac tromethamine. Conclusion: From all the results it can be concluded that the NonsteroidalAnti-Inflammatory Ketorolac has enhanced trans-corneal permeation and reduced corneal hydration when formulated with amino acid transporters by the pro-drug approach in ophthalmic solutions as the formulated pro-drugs have revealed high vitreal drug concentration.

Forecasting the possibility of neonatal early onset sepsis based on perinatal risk factors

Background: Neonatal sepsis remains a leading cause of neonatal mortality and morbidity, diagnosis of which remains difficult due to variable presentations. With the increasing threat of antimicrobial resistance, it is important to identify perinatal risk factors which are associated with higher incidence of definite sepsis, to initiate empirical antibiotics, while awaiting blood culture reports.Methods: This was hospital based cross-sectional study done in SVPPGIP, Cuttack, Odisha during January 2019 to April 2019, enrolling all neonates  ≥37 weeks gestation and aged less than 72 hours, with suspected early onset sepsis. Neonates with TORCH infections, congenital anomalies, syndromic baby or with surgical conditions were excluded. After obtaining informed consent, blood culture was sent for all and their perinatal risk factors noted. Blood culture positive newborns were considered to have definite sepsis. Data was analysed with Chi-square test and percentages, using SPSS 18.Results: Among the 200 cases, incidence of definite sepsis was 26%. The most common risk factor was low birth weight and birth asphyxia. Majority (67%) had single or lesser risk factor and number of risk factors was significantly associated with definite sepsis. A significant association was seen between blood culture positivity with low birth weight (p=0.003), foul smelling liquor (p= 0.025), birth asphyxia (p 0.018) and premature rupture of membranes (p= 0.016). The combination of maternal fever and unclean vaginal examination was also significantly associated with the same.Conclusions: Protocols for initiating empiric antibiotics need to be formulated, taking into account the significant risk factors, in resource limited settings, to avoid resource and time wastage.

Self-medication with antimicrobials in children: a study in tertiary care hospital, Odisha, India

Background: Antimicrobial resistance is emerging as global threat to health, the injudicious use being linked to multiple reasons namely parental misconceptions, easy drug availability and previous experiences.' Children, due to frequent illnesses, are victims of this misuse and more than fifty percent of these drugs are self-medicated by caregivers. This study attempts to assess the trends associated with self-medication with antimicrobials in children and the factors associated with it.Methods: This is a hospital based cross-sectional study, among pediatric outpatients aged 1 month to 14 years, in SCBMCH and SVPPGIP, Cuttack, during March 2019 to September 2019. A structured dichotomous questionnaire was administered to caregivers, including details of socio-demography and antimicrobials self-medicated. A pilot study was done for period of 1 month, and questionnaire accordingly modified. Data was analysed with Chi- square test and percentages, using SPSS 18.Results: Among the 300 patients studied, prevalence of self-medication with antimicrobials was 21%. Most patients self-medicated on pharmacists' advice (44.4%), commonest reason being similar illness previously (41.3%). Fever (31.7%) and cold cough (28.6%) were usual conditions, with Azithromycin being most frequently administered. 54% of cases self-medicating antimicrobials, had errors of dose or duration, with 27% reporting side-effects. Child's age (p=0.042), father's age (p=0.044), mother's age (p=0.002), chronic illness in child (p=0.002) and type of family (p=0.011) were significantly associated with antimicrobial self-medication in children.Conclusions: The high prevalence of self-medication with antimicrobials mandates need to educate parents and enforce laws regarding illegal dispensing of these drugs, to reduce the threat from resistance.

Comparison of the Incidence of Post-operative Wound Infection between Skin Staples and Conventional Sutures in Abdominal Skin Closures.

Introduction: The type of suture material for skin closure is also reported to influence post-operative wound complications. However, several other studies have failed to demonstrate significant differences between different types of suture material. Materials and Methods: This study was conducted at M. S. Ramaiah hospitals, Bengaluru - 560 054, Karnataka, India, where 100 patients underwent abdominal skin closure with either staples or conventional vertical mattress suturing with Ethilon. Results: The present 1 year observational study was conducted in the Department of Surgery, M. S. Ramaiah Hospitals, Bengaluru - 560 054, Karnataka, during the year December 2014-November 2015. Data obtained was tabulated and analyzed in tables. Conclusion: The use of skin staples in low tension incision is easy, associated with low incidence of wound complications, provides good cosmetic outcome and also takes considerably less time for skin closure and thus recommend its use more frequently especially for closure of long and multiple incisions.

Breast filariasis diagnosed by fine needle aspiration cytology--a case report.

We report a case of female who presented with a lump in the right breast. Fine needle aspiration cytology of lump revealed numerous adult filarial worms. Common habitat of the adult filarial worms is the lymphatic vessels and lymph nodes of limbs and their occurrence in breast is uncommon.

Leucocyte and serum ascorbic acid levels in mothers and their newborn in semi-arid western India.

Leucocyte ascorbic acid (LAA) and serum ascorbic acid (SAA) have been estimated in 50 pregnant women, their newborn infants, and 14 non-pregnant women living in the semi-arid region of western India. LAA was significantly higher in the newborn as compared to their mothers, the mean values being 35.52 +/- 6.85 and 23.94 +/- 5.84 micrograms/10(8) cells, respectively (P less than 0.01). The sex and birth weight of the infant, however, did not influence its ascorbic acid status. Pregnant women had relatively lower SAA (0.81 +/- 0.22 mg/dl) and LAA (23.94 +/- 5.84 micrograms/10(8) cells) as compared to the matched non-pregnant group (1.01 +/- 0.26 mg/dl and 29.98 +/- 8.45 micrograms/10(8) cells). But despite the semi-arid, draught prone geographical region and the hemodilution which accompanies pregnancy, none of the mothers had a clearly subnormal vitamin C status.